Often when we write about the global provision of O&P, we focus on differences between care in higher- and lower-resourced countries, as there are often challenges in providing enough clinicians to treat patients and the availability and affordability of components. Despite the relative similarity in available technology and clinics among industrialized countries, there are still differences in the care models used. In this issue, we discuss how our neighbors to the north and across the pond practice O&P.
“One Common Language: International Perspectives on O&P Standards”discusses the role of standard descriptions of care and the impact of reimbursement models on O&P in Canada, the United Kingdom, and Germany. In Canada and Germany, compendiums of care are serving as repositories for best practices in treatment options, outcome measurements data, and standardization of language for O&P interventions. While neither the Canadian Compendium of Prosthetic and Orthotic Treatment nor Germany’s five-part Compendium was designed with an external audience in mind, individuals involved in each report that the common nomenclature established in the documents and consistency in recommended treatment protocols have helped payers and other healthcare professionals better understand the services O&P professionals provide. In Canada, where funding is defined regionally, the compendium’s focus on O&P treatment that remains the same from province to province helps to facilitate the reimbursement conversation. And in the United Kingdom, the timing and specific intervention offered may differ based on whether the patient is receiving care within the National Health Service or through a private provider.
Many of us have had the experience of seeing a nurse practitioner at our general health practitioner’s office. In the United Kingdom, this model has been extended to a variety of allied healthcare professionals, including orthotists. Laura Barr reflects on her role as an advance practitioner in Scotland in “My Journey to Advanced Orthotic Practice in the UK.”
Finally, in “Social Distance, Disability, and Culture,” we explore the way we may resist close relationships with those we perceive as different from ourselves,
including people with disabilities and from other cultures. The article discusses how this tendency can interfere with clinical care, and how conscious awareness can increase sensitivity to individual patients’ needs and improve their care.
I hope you enjoy this issue exploring how other areas of the world engage in the important work of O&P.